| NPI | 1174216543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0019397) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 0019397) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-09-25 |